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Affiliations & Recognition

The Joint Commission Gold Seal of Approval The Joint Commission Gold Seal of Approval

 National Eating Disorders Association National Eating Disorders Association

 International Association of Eating Disorder Professionals International Association of Eating Disorder Professionals

 Academy for Eating Disorders Academy for Eating Disorders

 National Association of Anorexia Nervosa and Associated Disorders National Association of Anorexia Nervosa and Associated Disorders

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Orthorexia Symptoms and Effects

What are the Signs and Symptoms of Orthorexia?

Orthorexia is the term for a condition that includes symptoms of obsessive behavior in pursuit of a healthy diet. Orthorexia sufferers often display signs and symptoms of anxiety disorders that frequently co-occur with anorexia nervosa or other eating disorders.

A person with orthorexia will be obsessed with defining and maintaining the perfect diet, rather than an ideal weight. She will fixate on eating foods that give her a feeling of being pure and healthy. An orthorexic may avoid numerous foods, including those made with:

  • Artificial colors, flavors or preservatives
  • Pesticides or genetic modification
  • Fat, sugar or salt
  • Animal or dairy products
  • Other ingredients considered to be unhealthy

Common behavior changes that may be signs of orthorexia may include:

  • Obsessive concern over the relationship between food choices and health concerns such as asthma, digestive problems, low mood, anxiety or allergies
  • Increasing avoidance of foods because of food allergies, without medical advice
  • Noticeable increase in consumption of supplements, herbal remedies or probiotics / macrobiotics
  • Drastic reduction in opinions of acceptable food choices, such that the sufferer may eventually consume fewer than 10 foods
  • Irrational concern over food preparation techniques, especially washing of food or sterilization of utensils

Similar to a woman suffering with bulimia or anorexia, a woman with orthorexia may find that her food obsessions begin to hinder everyday activities. Her strict rules and beliefs about food may lead her to become socially isolated, and result in anxiety or panic attacks in extreme cases. Worsening emotional symptoms can indicate the disease may be progressing into a serious eating disorder:

  • Feelings of guilt when deviating from strict diet guidelines
  • Increase in amount of time spent thinking about food
  • Regular advance planning of meals for the next day
  • Feelings of satisfaction, esteem, or spiritual fulfillment from eating "healthy"
  • Thinking critical thoughts about others who do not adhere to rigorous diets
  • Fear that eating away from home will make it impossible to comply with diet
  • Distancing from friends or family members who do not share similar views about food
  • Avoiding eating food bought or prepared by others
  • Worsening depression, mood swings or anxiety

What are the Effects of Orthorexia?

Orthorexia symptoms are serious, chronic, and go beyond a lifestyle choice. Obsession with healthy food can progress to the point where it crowds out other activities and interests, impairs relationships, and even becomes physically dangerous. When this happens, orthorexia takes on the dimensions of a true eating disorder such as anorexia or bulimia. One effect of this drive to eat only the right foods (and perhaps only in the right ways) is that it can give a person with orthorexia a sense of superiority to others. This can put a strain on relationships with family and friends, as relationships become less important than holding to dietary patterns.

Maintaining an obsession with health food may cause a restriction of calories merely because available food isn't considered to be good enough. The person with orthorexia may lose enough weight to give her a body mass index consistent with someone with anorexia (i.e., less than 18.5). If the dietary restrictions are too severe, malnutrition can result. In rare cases, particularly in the case of women with unaddressed co-occurring disorders or another addiction, orthorexia may result in severe malnutrition and weight loss, which can cause cardiac complications or even death.

How are Anorexia Nervosa and Orthorexia Similar?

Orthorexia is a term with varying levels of acceptance in the eating disorder treatment community. Some eating disorder specialists regard orthorexia as a discrete diagnosis like anorexia nervosa or bulimia nervosa. Others, however, believe that patients with orthorexia symptoms are actually suffering from anorexia. Sufferers of orthorexia and anorexia may show similarities such as:

  • Desire to achieve control over their lives through control of food intake
  • Seeking self-esteem and spiritual fulfillment through controlling food intake
  • Citing undiagnosed food allergies as rationale for avoiding food
  • Co-occurring disorders such as OCD or obsessive compulsive personality disorder
  • Elaborate rituals about food that may result in social isolation

How are Orthorexia and Anorexia Nervosa Different?

Obsession with weight is one of the primary signs of anorexia, bulimia, and other eating disorders, but is not a symptom of orthorexia. Instead, the object of the orthorexic's obsession is with the health implications of their dietary choices. While a person with anorexia restricts food intake in order to lose weight, a person with orthorexia wants to feel pure, healthy and natural. The focus is on quality of foods consumed rather than quantity.

Signs and symptoms of eating disorders must be evaluated in the context of a person's feelings, emotions, and self esteem. It's crucial to seek appropriate clinical advice from a professional with experience treating orthorexia, anorexia and other psychiatric conditions. The obsessive tendencies associated with orthorexia can indicate a co-occurring disorder that should be diagnosed and treated by a psychiatrist.

What Should Parents or Friends Say If They Are Concerned?

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Orthorexia is a very serious eating disorder, particularly if it is accompanied by co-occurring psychiatric or addictive disorders, and significant weight loss or dietary imbalance. Like anorexia nervosa, bulimia nervosa, and other eating disorders, orthorexia is a medical disease that can result in irreversible health complications, including death. Learn more about orthorexia treatment for women and girls (ages 12 and up) at Timberline Knolls Residential Treatment Center.

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